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Axis V – Global Assessment of Functioning Scale (GAF), further evaluation of the self-report version

Published online by Cambridge University Press:  16 April 2020

A. Ramirez ,
L. Ekselius  and
M. Ramklint
A. Ramirez
Affiliation:
Department of Neuroscience, Psychiatry UAS, University Hospital, ing 87, SE-751, 85 Uppsala, Sweden
L. Ekselius
Affiliation:
Department of Neuroscience, Psychiatry UAS, University Hospital, ing 87, SE-751, 85 Uppsala, Sweden
M. Ramklint*
Affiliation:
Department of Neuroscience, Psychiatry UAS, University Hospital, ing 87, SE-751, 85 Uppsala, Sweden
*
*Corresponding author. Tel.: +46 18 6115233; fax: +46 18 51 58 10. E-mail address: mia.ramklint@bupinst.uu.se (M. Ramklint).
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Abstract

Objective

The study aimed to examine agreement between patients' and professional staff members' ratings on the Global Assessment of Functioning scale (GAF).

Methods

A total of 191 young adult psychiatric outpatients were included in a naturalistic, longitudinal study. Axis I and axis II disorders were assessed by means of the Structured Clinical Interview for DSM-IV. Before and after treatment, patients and trained staff members did a GAF rating. Agreement between GAF ratings was analyzed using the intra-class correlation coefficient (ICC).

Results

The overall intra-class correlation coefficients before and after treatment were 0.65 and 0.86, respectively. Agreement in different axis I diagnostic groups varied, but was generally lower before treatment as compared to after treatment (0.50–0.66 and 0.78–0.90, respectively). Excessive psychiatric co-morbidity was associated with the lowest inter-rater reliability. Agreement, with respect to change in GAF scores during treatment, was good to excellent in all groups.

Conclusion

Overall, agreement between patients' and professionals' ratings on the GAF scale was good before and excellent after treatment. The results support the usefulness of the self-report GAF instrument for measuring outcome in psychiatric care. However, more research is needed about the difficulties in rating severely disordered patients.

Keywords

Axis VGlobal assessment of functioningGAFSelf-report instrumentTreatment outcomes

Information

Type
Original article
Information
European Psychiatry , Volume 23 , Issue 8 , December 2008 , pp. 575 - 579
Copyright
Copyright © Elsevier Masson SAS 2008

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References

APA. Diagnostic and statistical manual of mental disorders 3rd ed., rev. Washington DC, 1987.Google Scholar
APA, Diagnostic and statistical manual of mental disordersDSM-IV 4th ed.Washington DC: American Psychiatric Association; 1984.Google Scholar
Bodlund, .Kullgren, .Ekselius, .Lindström, .von Knorring, .Axis V-global assessment of functioning scale: evaluation of a self-report version Acta Psychiatr Scand. 90 1994 342–347CrossRefGoogle ScholarPubMed
First, M.Spitzer, R.Gibbon, .Williams, J.B.Structured clinical interview for DSM-IV axis I disorders, clinical version (SCID-CV) Washington, D.C: American Psychiatric Press, Inc.; 1996.Google Scholar
First, M.Spitzer, R.Gibbon, .Williams, J.B.Structured clinical interview for DSM-IV personality disorders (SCID-II) Washington, D.C: American Psychiatric Press, Inc.; 1997.Google Scholar
Goldman, H.Skodol, A.Lave, T.Revising axis V for DSM-IV: a review of measures of social functioning Am J Psychiatry. 149 1992 1148–1156Google ScholarPubMed
Hilsenroth, M.Ackerman, S.Blagys, M.Baumann, B.Baity, M.Smith, S.et al.Reliability and validity of DSM-IV axis V Am J Psychiatry. 157 2000 1858–1863CrossRefGoogle ScholarPubMed
Janca, .Reliability of DSM-IV axis V scales Am J Psychiatry. 158 2001 1935–1937CrossRefGoogle ScholarPubMed
Jones, S.Thornicroft, .Coffey, .Dunn, .A brief mental health outcome scale-reliability and validity of the global assessment of functioning (GAF) Br J Psychiatry. 166 1995 654–659CrossRefGoogle Scholar
Kellner, .Rada, R.Andersen, .Pathak, .The effects of chlordiazepoxide on self-rated depression, anxiety, and well-being Psychopharmacology (Berl). 64 1979 185–191CrossRefGoogle Scholar
Loevdahl, .Friis, .Routine evaluation of mental health: reliable information or worthless “guesstimates”? Acta Psychiatr Scand. 93 1996 125–128CrossRefGoogle ScholarPubMed
Moos, R.McCoy, .Moos, B.Global assessment of functioning (GAF) ratings: determinants and role as predictors of one-year treatment outcomes J Clin Psychol. 56 2000 449–4613.0.CO;2-8>CrossRefGoogle ScholarPubMed
Moos, R.Nichol, A.Moos, B.Global assessment of functioning ratings and the allocation and outcomes of mental health services Psychiatr Serv. 53 2002 730–737CrossRefGoogle ScholarPubMed
Piersma, H.Boes, J.The GAF and psychiatric outcome: a descriptive report Community Ment Health J. 33 1997 35–41CrossRefGoogle ScholarPubMed
Pinto, O.Akiskal, H.Lamotrigine as a promising approach to borderline personality: an open case series without concurrent DSM-IV major mood disorder J Affect Disord. 51 1998 333–343CrossRefGoogle ScholarPubMed
Rund, B.Moe, .Sollien, .Fjell, .Borchgrevink, .Hallert, .et al.The psychosis project: outcome and cost-effectiveness of a psychoeducational treatment programme for schizophrenic adolescents Acta Psychiatr Scand. 89 1994 211–218CrossRefGoogle ScholarPubMed
Salvi, .Leese, .Slade, .Routine use of mental health outcome assessments: choosing the measure Br J Psychiatry. 186 2005 146–152CrossRefGoogle ScholarPubMed
Shrout, P.Fleiss, J.Intraclass correlations: uses in assessing rater reliability Psychol Bull. 86 1979 420–428CrossRefGoogle ScholarPubMed
Skodol, A.Pagano, M.Bender, D.Shea, M.Gunderson, J.Yen, .et al.Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years Psychol Med. 35 2005 443–451CrossRefGoogle ScholarPubMed
Soderberg, .Tungstrom, .Armelius, B.Reliability of global assessment of functioning ratings made by clinical psychiatric staff Psychiatr Serv. 56 2005 434–438Google ScholarPubMed
Startup, .Jackson, M.Bendix, .The concurrent validity of the global assessment of functioning (GAF) Br J Clin Psychol. 41 2002 417–422CrossRefGoogle Scholar
Vatnaland, .Vatnaland, .Friis, .Opjordsmoen, .Are GAF scores reliable in routine clinical use? Acta Psychiatr Scand. 115 2007 326–330CrossRefGoogle ScholarPubMed
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